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Forum Name: Pediatric Topics

Question: Premature baby with undeveloped lungs & polycyctic kidney


 prematurebaby - Sun May 03, 2009 11:24 am

Dear Dr.,

My wife was in her 32nd week when she went into labor. I rushed her to the hospital and the doctor said the baby will die if she doesn’t take the baby out by C-section. So, after the operation they took the baby and placed him in an incubator and hooked him up to all sort of machines (ventilator and stuff with red light etc). After the first day they removed the ventilator because no need the baby will be okay without but they put oxygen support (something that is hooked up to the baby’s nose). However, the baby got worst (his face got darker and he looked pale) after they removed the ventilator. Is this a bad medicine practice or this is normal!? Trail and error!! The baby has the following problems:

1) Has undeveloped lungs
2) The baby breathes faster than normal
3) The baby has a polycystic kidney

I hope a doctor could tell me briefly what to expect (Is it possible that his undeveloped lungs will improve!!? If yes, when should I expect the results?) What is the best course of action? Should they wait for his lungs to develop or should they start assessing the polycystic kidney?

I kindly thank you for your time and help. I am looking forward to hearing from you soon.

Sincerely yours,

A concerned father
 Dr. Chan Lowe - Sun Jul 12, 2009 8:34 pm

User avatar Hello Prematurebaby,

Unfortunately this is actually a fairly complicated issue, difficult to fully explain in the context of the internet. I would advise you to talk with the neonatologist (newborn intensive care specialist) to get more specifics about your baby.

I can give you some information that may be helpful, though. Lung development varies some but in general, babies lungs are fully developed by about 34 weeks. At 32 weeks, the lungs may or may not be sufficiently developed to allow for unlabored breathing. It sounds as if your baby was not quite fully developed. They can continue to develop after the baby is born although there is an increased risk of longer lasting difficulties so the baby will need to be followed closely for this.

Regarding the ventilator, it is not uncommon for a baby to be showing signs that they are ready to be taken off then subsequently need to be put back on. The issue here is balancing so that the baby doesn't stay on the ventilator longer than necessary. Being put back on the machine is not necessarily a bad thing. It just means your child will need some more time before the next trial off the machine.

The kidneys may or may not be related. If there was not good urine output from the baby's kidneys, the amniotic fluid does not increase properly and this can lead to decreased lung development. Your neonatologist can help clarify this issue if needed.

I hope this helps. Best wishes.
 prematurebaby - Sat Jul 25, 2009 3:11 pm

Thank you so much doctor. My baby is doing fine now and everything seems to be okay with his lungs. He was diagnosed with multi-cystic dyplastic right kidney. The doctor said we will have to wait until he is between 3 to 5 years before he can tell us what to exactly do. Options removal of the right kidney if it started causing problems or secondly wait until the kidney disappears by itself.

Thank you again.

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